This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. The CNS consortium titled "New Approaches To Brain Tumor Therapy (NABTT)" is specifically designed to combine and focus the experience, resources and capabilities of thirteen outstanding institutions (Brown University, Columbia University, Emory University, Henry Ford Health Science Center, Johns Hopkins, Mass General Hospital, Lee Moffitt Cancer Center, Northwestern University, University of Alabama, University of Pennsylvania, University of Texas-San Antonio, Wake Forest University, and Washington University) to bear on primary brain tumors. The size of the consortium has grown from seven to thirteen institutions. This expands the consortium's ability to carry out clinical trials, broadens the laboratory research resources from which to develop new clinical trials, expands the cooperative, interactive theme which is the driving force behind this NCI sponsored RFA. The primary objective of the NABTT CNS Consortium is to improve the therapeutic outcome for adults with primary brain tumors. This consortium is one of two nationwide that is funded by the National Cancer Institute to conduct Phase I and II clinical evaluations of promising new treatment strategies (surgery, radiation, chemotherapy, and biologic therapies), routes of admistration, and clinical trial design in the treatment of primary malignancies of the central nervous system. The participating institutions have (1) a large number of adult patients with primary brain tumors, (2) expert multidisciplinary clinical teams caring for these patients, (3) extensive clinical and laboratory resources, (4) a striking number of ongoing high quality, clinically relevant, peer-reviewed and NIH funded clinical and laboratory brain tumor research projects, (5) nationally recognized expertise in oncology, pharmacology, new drug development, Phase I and II clinical trials, neurosurgery, and neuropathology, (6) extensive expertise in biostatistics, data management, and the coordination of multi-institutional studies, and (7) exceptional reputations for excellence in clinical care and research. The consortium adds to these strengths with a well-defined and smoothly functioning organizational structure, and emphasis on clinical trial design, protocol development, quality control, study monitoring, and data management and analysis. The secondary objective of the NABTT CNS Consortium is to share human brain tumor specimens and clinical and laboratory data to conduct additional research pertaining to (1) the basic biology of primary brain tumors, (2) the neuro-pharmacology of new therapies for primary brain tumors, and (3) improving the care and quality of life of adults with primary brain tumors. Our hypothesis is that therapeutic progress for brain tumor patients will arise from treatments rationally developed based on laboratory hypothesis driven research. Furthermore, that effective new treatments will be developed most efficiently through well controlled multi-institutional clinical trials. The primary long-term objective of this proposal is thus to improve the therapeutic outcome for adults with primary brain tumors. This will be accomplished by participating in Phase I and II clinical evaluations of promising new agents, biologic approaches, and routes of administration in the treatment of primary malignancies of the central nervous system (CNS) through the CNS. The proper diagnosis of tumor status upon initial presentation and the evaluation of the effect of treatment using multi-modality neuroimaging approaches are integral and essential parts of this aim. Conventional MRI is extremely sensitive for the detection of brain lesions;however, its diagnostic specificity, such as its ability to distinguish tumor type, grade, or separate tumor regrowth from radiation necrosis, is limited. As such, we have benefited greatly from the developments in the Research Resource over the past 4 years allowing to acquire more modalities (particularly physiological imaging techniques) more rapidly at 3T, and we will collaborate actively in evaluating the promising new methodologies that are being designed in TRDs 1-3.